Background: There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer.

Methods: All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA) manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed.

Results: A total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies). Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%), knee (20%), hip (19%), sacroiliac joint (13%) and lumbar (11%). For soft tissue therapies it was gluteal (22%), hip flexor (14%), knee (12%) and lumbar (11%). The most common symptomatic regions treated with joint therapies were lumbar (25%), thoracic (15%) and hip (14%). For soft tissue therapies it was gluteal (22%), lumbar (15%) and posterior thigh (8%). Of the joint therapy, 56% was HVLA manipulation only, 36% high-HVLA and mobilization and 9% mobilization only. Of the HVLA manipulation, 63% was manually performed and 37% mechanically assisted.

Conclusions: The intervention applied was multimodal and multi-regional. Most treatment was for asymptomatic benefit, particularly for joint based therapies, which consisted largely of HVLA manipulation techniques. Most treatment was applied to non-local hamstring structures, in particular the knee, hip, pelvis and spine.

Figure 1: Breakdown of joint based therapy into region and as being for symptomatic or asymptomatic benefit.

Mentions:
Figure 1 demonstrates the breakdown of joint based therapy into that for symptomatic and asymptomatic benefit. Of the total joint based therapy 73.5% was for asymptomatic benefit and 26.5% symptomatic benefit. The most common regions treated for asymptomatic benefit were the thoracic spine (21.3%), knee (20.5%), hip (19.0%), sacroiliac joint (12.5%) and lumbar spine (11.1%). The most common regions treated for symptomatic benefit were the lumbar spine (24.3%), thoracic spine (16.7%), hip (14.0%), cervical spine (13.3%), sacroiliac joint (10.8%) and knee (10.4%). Of interest the following ratios of asymptomatic: symptomatic treatment occurred at the knee (5.5:1), hip (3.8:1), thoracic spine (3.6:1), sacroiliac (3.2:1), and lumbar spine (1.3:1).

Figure 1: Breakdown of joint based therapy into region and as being for symptomatic or asymptomatic benefit.

Mentions:
Figure 1 demonstrates the breakdown of joint based therapy into that for symptomatic and asymptomatic benefit. Of the total joint based therapy 73.5% was for asymptomatic benefit and 26.5% symptomatic benefit. The most common regions treated for asymptomatic benefit were the thoracic spine (21.3%), knee (20.5%), hip (19.0%), sacroiliac joint (12.5%) and lumbar spine (11.1%). The most common regions treated for symptomatic benefit were the lumbar spine (24.3%), thoracic spine (16.7%), hip (14.0%), cervical spine (13.3%), sacroiliac joint (10.8%) and knee (10.4%). Of interest the following ratios of asymptomatic: symptomatic treatment occurred at the knee (5.5:1), hip (3.8:1), thoracic spine (3.6:1), sacroiliac (3.2:1), and lumbar spine (1.3:1).

Bottom Line:
Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions.A total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies).Most treatment was for asymptomatic benefit, particularly for joint based therapies, which consisted largely of HVLA manipulation techniques.

Background: There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer.

Methods: All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA) manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed.

Results: A total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies). Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%), knee (20%), hip (19%), sacroiliac joint (13%) and lumbar (11%). For soft tissue therapies it was gluteal (22%), hip flexor (14%), knee (12%) and lumbar (11%). The most common symptomatic regions treated with joint therapies were lumbar (25%), thoracic (15%) and hip (14%). For soft tissue therapies it was gluteal (22%), lumbar (15%) and posterior thigh (8%). Of the joint therapy, 56% was HVLA manipulation only, 36% high-HVLA and mobilization and 9% mobilization only. Of the HVLA manipulation, 63% was manually performed and 37% mechanically assisted.

Conclusions: The intervention applied was multimodal and multi-regional. Most treatment was for asymptomatic benefit, particularly for joint based therapies, which consisted largely of HVLA manipulation techniques. Most treatment was applied to non-local hamstring structures, in particular the knee, hip, pelvis and spine.